HomeMy WebLinkAbout0024755-Electric (service change) CITY OF OSHKOSH N°_ 24755
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC 1A/FICBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS � �/� �' �
PLAN NO.
OWNER `�
DESIGNER
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USE /NATURE OF WORK�-'t- J
4P, 3 e 3 - /ra o
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR eac� --�-
Electric Serv. New ❑ Change E ❑ Type'CZ Volts` Amps 7"
Fixtures Switches Receptacles Circuits di9)
PLUMBING CONTRACTOR
BT WH Disp WSoft CBasin
Lav _ Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
O t✓
FEES: Valuation $ DO Permit Fee Paid $ � � G
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� Park Dedication $
ISSUED BY Date /-Z 7/ Final /O.P. — Zs= F/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE . /
/ • : NT/. NER DATE
ADDRESS
TELEPHONE #
PERMIT NO . z/7Sj . APPL . DATE C ---/ T- 7/
ELEC. CONTR.
OWNER - ..
ADDRESS / 7'- ,
NATURE OF WORK
ELEC. SERV. NEW CHANGE A TEMP.
DESC. TYPE 2 - .10 . Y - Vt/VOLTS i --'1 6 AMPS/ ZI U
FIX'S ` SW'S ,x RECEPT'S CIRC'S
APPLIANCES V
SIGNS (b4 Q
INSP. ROUGHIN SERVICEO 4 -f'/ FINAL( - /g'?/
EST. COST t9d r '✓ PERMIT FEE a (9..2_- DATE PD S 9-91
REMARKS
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